Developing a Skilled Oncology Workforce in Low-Resource Settings
Perhaps the most challenging aspect of building oncology capacity in low-resource setting is the critical shortage of trained cancer specialists. Dana-Farber's Center for Global Cancer Medicine (CGCM) has implemented numerous successful initiatives to assist in oncology education and workforce training through our long-term partnerships with the Butaro Cancer Center of Excellence in Rwanda and the University Hospital of Mirebalais in Haiti.
Close collaborations with the global health care delivery non-profit Partners In Health — as well as with other academic global cancer programs around the world — have been vital to these efforts. The focus of our work has been both to educate and mentor clinicians in country and to provide ongoing clinical support through a wide variety of programs and exchanges. To accomplish these stated goals, we continue to look for innovative ways to optimally utilize new communication technologies to supplement our training efforts in-country.
Physician/Nursing Oncology Training
Since 2012, CGCM senior oncology physicians and nurses have traveled to both Rwanda and Haiti on an ongoing basis to educate and mentor clinicians in cancer medicine. As part of this work, CGCM providers have also helped evaluate and develop the necessary systems to deliver advanced cancer care at those sites.
Remote Tumor Boards/Clinical Support
CGCM runs weekly tumor boards with clinicians in Rwanda and Haiti. Led by senior oncology advisors from Dana-Farber and its academic partners, the conferences assist in real-time cancer case management (adult/pediatric) and play an important educational role for the local oncology team. CGCM complements its weekly tumor boards with monthly case-based didactic presentations using the Project Echo (Extension for Community Healthcare Outcomes) model, which aims to educate health care professionals in underserved communities. In addition, our physician advisors engage in ongoing communication with colleagues in-country to assist with cancer care management.
Clinical Treatment Protocol Development
A key component of our educational efforts has been the development and implementation of clear clinical pathways for the management of the most commonly seen cancers in the low-resource areas where we work. Ongoing review and updates allow these protocols to evolve over time as new diagnostic and therapeutic tools are introduced.
Our clinicians have travelled to Rwanda and Haiti to spend extended periods of time teaching on the oncology wards and lecturing on relevant topics. In addition, many of our specialists have presented short, focused training courses as new services are introduced.
An observership program has been initiated, through which clinicians from Rwanda and Haiti travel to Dana-Farber to spend one to two months receiving intense oncology mentorship from our clinical teams. This effort serves to educate physicians and nurses from the sites where we work and fosters long-term relationships between in-country providers and their U.S.-based colleagues.